We have completed our review of the October 2026 current procedural terminology (CPT) including any category II performance measurement tracking codes and Category III temporary codes for emerging technology. These updates will be added to our claims processing system and are effective October 1, 2026. The lists include codes that have special coverage or payment rules for standard products. (Some employers may customize their benefits.) We have included codes for services that are:

• “Not Covered” – This includes services not covered in the main member certificate (e.g., covered as a prescription drug).
• “Not Medically Necessary” – This indicates services where there is insufficient evidence to support it.
• “Not Separately Reimbursed” – Services that are not separately reimbursed are generally included in payment for another service or are reported using another code and may not be billed to your patient.
• “Subject to Medical Review” – Preauthorization is recommended for commercial products and required for BlueCHiP for Medicare.
• “Invalid” – Use alternate procedure codes, such as a CPT or HCPCS code.
• “Medicare Lab Network” – Codes that are reimbursed to a hospital laboratory outside of the laboratory network, physicians, or urgent care center providers for BlueCHiP for Medicare.
• “Pending CMS determination” – For BlueCHiP for Medicare Category III codes.

Please submit your comments and concerns regarding coverage and payment designations to:

Email: Medical.Policy@bcbsri.org

Mail:   Blue Cross & Blue Shield of Rhode Island

Attention: Medical Policy, CPT Review

500 Exchange Street

Providence, Rhode Island 02903

Please note that as a participating provider, it is your responsibility to notify members about non-covered services prior to rendering them.

*CPT is a registered trademark of the American Medical Association.

October 2026 CPT Updates:

Please note: Coverage and/or payment rules for code(s) below may be subject to change for Medicare Advantage Plans and/or Commercial Products.

Additionally, coverage may vary for those Commercial Products that have opted out of the Biomarker Testing Mandate.

The following codes are covered and separately reimbursed for Professional and Institutional providers for Medicare Advantage Plans and Professional and Institutional providers for Commercial Products Opt-In and Opt-Out groups:

87638 *Effective 5/15/2026   0669U 

The following code(s) are covered and separately reimbursed for Medicare Advantage Plans and Commercial Products for Professional and Institutional Providers: 

1059T

The following codes are covered and separately reimbursed for Professional and Institutional providers for Medicare Advantage Plans and Professional and Institutional providers for Commercial Products Opt-In groups and not covered for Commercial Opt-Out groups:

0684U 0685U

The following code(s) will be not covered, provider liable, for Medicare Advantage Plans and Commercial Products for both Opt-In and Opt-Out groups for Professional and Facility providers: 

0687U

The following codes are subject to medical review for Professional and Institutional providers for Medicare Advantage Plans and Commercial Products Opt-In groups and not covered for Commercial Products Opt-Out groups: 

0660U 0661U 0662U 0663U 0664U 0665U 0666U 0667U 0668U 0670U 0671U 0672U 0673U 0674U            0675U 0676U 0677U 0678U 0679U 0680U 0681U 0682U 0683U 0686U 0688U 0689U

0690U 0691U 0692U 0693U 0694U 0695U 0696U 0697U 0698U 1063T  1064T  1097T  1106T 1107T  

The following code(s) will be covered but not separately reimbursed for Medicare Advantage Plans and Commercial Products for Professional and Institutional Providers: 

1069T  1070T  1071T  1072T  1073T  1074T  1075T  1076T  1077T  1078T

The following code(s) are subject to medical review and separately reimbursed for Professional and Institutional providers for Medicare Advantage Plans and will be not medically necessary for Commercial Products for Professional and Institutional Providers: 

1054T  1055T  1056T  1057T  1058T  1060T  1061T  1062T  1065T  1066T  1067T  1068T  1079T

1080T  1081T  1082T  1083T  1084T  1085T  1087T  1088T  1089T  1090T  1091T  1092T  1093T

1094T  1095T  1096T  1098T  1099T  1100T  1101T  1102T  1103T  1104T  1108T  1109T  1110T

1111T

The following code(s) will not covered for Medicare Advantage Plans and not medically necessary for Commercial Products for Professional and Institutional Providers:

1105T

The following code(s) will be separately reimbursed and covered for Medicare Advantage Plans and not medically necessary for Commercial Products for Professional and Facility Providers: 

1086T